AF - 35004_�.
/�c�
v� .
�� � , C
�.T.._._.� �.�. i .�.� �
From 'Fhe Desk Of
RICFIRRD N. SOBIECH
PUBLIC WORKS DIRECTUR
DA�E: 8131I77 -
�UBJECT:
Erosion Probletu on Stinaki Progerty
in North'Innsb�uck
,
,= �, .�
,
_.
MEMQRANDUM TC337
Mr. Jim Johnson called and indicated a.coacern with the referenced item. Could
you please review the situation and perhaps make contact with Mr. Stinski to see
if he still intenda to develop the lot, in particular, complete the storm aewer
pipe on the south property �ine? . _
. . nsl3 . _.
,
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843i UPIiYEQ1SITY AVEPlUE N.E., F�IOLEY. BIIINNESQTA b843Z
TELEPi10NE ( 612�871-3A80
st 3, 1978
Mr. Gerald Stepaaiak
Step Coastructivn Co., Tac.
866 2nd Ave. NW ,
tiew Bri�hton, �i 55112
Res C3ty to Supplp Castings at 5681 Arthur Street NE
Dear Mr. Steganiak:
�lease be adviseci the Citp of Fridley will pruvide the
castings for the storm sewer structures iastalled by yau
�.t the referenced property.
Depending upon the firial landscaping, apprvpriate coqers
or grates will be utilized to ensure proper dratnage.
k,
Yuurs verq tsuly,
Richard N. Sobieeh, P.E.
Public Works Director
RNS/ jm
t: .
�
sue�etr " � ' PER
City of Fridley -�� -� _. 10 61
�
AT THE TOP OF THE TWINS �� L D 1 N G P E R M I
RECEtPT NO.
� � COMMUNITY OEVELOPMENT DIV. � ��
i VV �
r � �� � PROTECTIVE INSPECTION SEC.
1 . i
i--__ A �r'�';', CITY NALL FRIOIE� jS1.li NUMBEA pEV OATE PAGE O� APP110VE0 BY
L �� bt2—s��-3450 9t0-F18 6I13/o0 / /
108 AOpRESS 5681 Arthur Street
t LEGAL LOT O. BIOCK TRACI' OR A�dITION SEE ATTACNED
oescR. 1 1 Innsbruck North SFIEET
2 PROPERTY OWNER MAII AODRES$ Z�P PMONE
Derek Shannon 5681 Arthur Street 782-9682
3 CONTRACTOR MAIL AOORE33 Z�P PNONE IICENSE NO
Design Images 13971 Holl St. NW Cedar MN 55011 763-754-0229
4 ARCMITECTORDESIGNER MAILADORESS ZIP PMONE LICENSENO.
S ENGINEER MAIL AD4pE$S . 21P PNpNE LICENSE NO
8 USE OF BUILDINti
Residential
7 CIASS Of WORK
�7 NEW ❑ ADOITION O ALTERATION ❑ REPAIR O MOVE O REMOVE
8 OESCRIBE WOfiK ys'x 3a` �f.t��C-Lr/.� ���l ` x�'�` �oR-���
Wood Frame new home
9 CHANGE OF USE FROM TO
STIPULATIONS .
For stipulations, see attached plan. 1���Q $��� `�� ���
` TYpE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
SEPARATE PERMITS ARE REOUIRED FOFi ELECTfiICAL, PIUMBING, MEATING,
VENTILATING OR AIR CONOITIONINfi.
THIS PERMIT BECOMES NULL AND VOIO If WORK Oii CpNSTRUCTION ZONING SO. FT CU. fT.
AUTMORIZED IS NOT COMMENCED V�(ITHIN 80 DAYB, OR IF CONSTRUCTION
OR WORK IS SUSPENOED OR AQANDON�O FOp A PERIOO OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DW4G. UNITS OfFSTREET PARKING
I MEREBY CERTIFV THAT 1 NAVE REAO ANO FXAM�NEO THIS APPIICATION 1 STALLS GAFAGES
AND KNOW TME SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF �AWS yALUAt10N � 18S � 71S . OO SURTAX � O
ANO OROINANCES GOVERNING TMIS TYPE Of WOiiK WIIL BE COMPLIEO r Q�
WITH WMETMEF SPECIFIEO MEREIN OFi NOT. TME GRANTING Of A PERMIT O 9L H /V-�
DOES NOT P E TO GIVE HOiitT O VIOLATE OR CANCEL TME pEpMIT FEE SAC CMARGE
PROVISION OF Y OTME E OCAL. LAW REGULATING CON- @
STRUCTIO , A E PERf NC CONSTFUCTION /�, Fire SC y� 1� 10� .0
� PLANCMECKFEE• TOTA�FEE �i_,ns(
6�3 0� License SC $5.00 $3,607.30 t�����,�r
S�GN4TUpfOFCON:NACTOpOpMUTNOp�IE00G8NT IOA �� EN PROPEpLV VAL,IDATEO TMIS IS �J PEF1M1
9
S�GN4TUNEO�OWNEp���OWNEABUROEp� � �TE� -QG_�N �161E
f
NEw t � o�y-y�-- G�1�
ADDN _ []
��R Il
Construction Address:
CR'1� OF FRIDLEIf
R
SINGLE FAMILY AND DUPLEXES R 9 AND R 2
-- ... BiJSL�-6�EF�lVI!-'�•P�PP�I�kTION
��.� .
Ef�ective 1/1/2000
(763) 572�604 Bldg Insp
,� ���
_ _ _ � =-- � l�(o (
,�P �
Legal Description: �-� T t Px.r� l ��' "' s a i�c. K. r►� o2�-t1-.
Owner Name 8� Address: i:����}���.+�+�t./ Tel. # �� z- '7 � Z- ^ 4�� Z
Contractor. �S� c.r--� S��� 5► MN LICENSE # z-os`j
Address: t'3°t't t 1���-vl •sT - N•�••�. Tel. #'ZS4 -oLZ°�
? �03-
LMNG AREA:
GARAGE AREA:
DECK AREA:
OTHER:
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Length Width Height Sq. Ft
Length Width Height Sq. Ft
Length Width Hgt/Ground Sq. Ft
t�oc7U 1—¢�Mr"C,, _C' c� l I�� On S
Construction Type: N�"� ��� Estimated Cost: $ Z-cav, cx�c� ����j ���
Driveway Curb Cut Width Needed: Ft + 6 F= Ft x$ _$
DATE: `/� APPUCANT: Tel. # 7 fo 3 7 S Y— oLL�
CITY USE ONLY - Cail (763) 572-3604 for Permit Fees if mailing in application
Permit Fee $�L� 7 3• 7.�� Fee Schedule on Reverse Side
Fire Surcharge $ ��S � 7D .001 of Permit Valuation (1/10th%)
State Surcharge $ Q� - 8� $.50/$1,000 Valuation
SAC Charge $- f/�� � 0.�$1100 per SAC Unit
License Surcharge $ ,�� �$5.00 (State Licensed Residential Contractors)
Driveway Escrow
Erosion Control
Park Fee
$ Alt. "A" or Alt. "B" Above
$ $450.00 Conseroation Plan Review
$ '�, � a Fee Determined by Engineering
Sewer Main Charge $ Agreement Necessary [] Not Necessary []
TOTAL
STIPULATIONS:
.$ �CO��% •�O
BUII.DING $ERNIIT FEE SCHEDULE
The Chief Building O�cial shall, l�fore issuing �ermits �or ti�e°erection of any building or stiucture, or for any
addition to any existing building or structure, or for any'alteration or repair to �iy .�xisting building or structure,
upon application therefore, require the payment by the applicant for suc� per�°`"� � of fees to the amount herein
below set forth and in the ma.nner herein provided to-wit: �
TOTAL VALUE
$1 to $500
$501 to $2,000
$2,001 to $25,000
$25,001 to $50,000
$50,001 to $100,000
$1�,001 to $500,000
$500,001 to $1,�,000
$1,�,001 and up
FEFS
$23.50
$23.50 for first $500 plus $3.05 for each additional $100 or
fraction thereof, to and, including $2,000
$69.25 for first $2,000 plus $14.00 for each additional $1,000
or fraction thereof, to and including $25,000
$391.25 for first $25,000 plus $10.10 for each additional $1,000
or fraction thereof, to and including $50,000
$643.75 for first $50,000 plus $7.00 for each additional
$1,0� or fraction thereof, to and including $100,000
$993.75 for first $100,000 plus $5.60 for each additional
$1,000 or fraction thereof, to and including $500,000
$3,233.75 for the first $500,000 plus $4.75 for each additional
$1,000 or fraction thereof, to and including $1,000,000
$5,608.75 for the first $1,000,000 plus $3.15 for each additional
$1,000 or fraction thereof
DRIVEWAY DEPRESSION ESCROW
(Concrete Ci�rb Streets Only) •
Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $15.50.
Alternate "B": Removal and replacement of curb and gutter and install a 3 foot wide
approach with 6 inch depth - Driveway width plus 6 feet times $23.25.
VERIFICATION OF FOUNDATION
Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper
review of the proposed structure and og the constru�aon site.
A Certificate of S�uvey of the lot, showing the location of the foundation once it has it has been constructed will
t� required before proceeding with the framing, New Houses Only
.,
-.
. ' ,
Project Address:
Contractor: Design Images
Phone: 754-0229
Date: 5/30/00
1) Determine Working Square Footage
Total Exposed Wall Area 2362.00 Sq. Ft. x"U" of 0.11
2) Determine Working Square Footage
Total R�f/Ceiling Area 1329.00 Sq. Ft. x"U" of 0.022
3) Determine Working Square Footage of Each
Total Window Area 204.00 Sq. Ft. x"U" of 0.42
Total Door Area 60.00 Sq. Ft. x"U" of 0.067
Total Sliding Glass Door Area 40.00 Sq. Ft. x"U" of 0.37
Total Fireplace Wall Area 0.00 Sq. Ft. x"U" of 0.049
Total Wail Framing 10% 236.2Q Sq. Ft. x"U" of 0.092
Total Net Wall 90% 2125.80 Sq. Ft. x"U" of 0.043
Total Rim Joist Area � 178.00 Sq. Ft. x"U" of 0.041
Total Foundation Window Area 6.00 Sq. Ft. x"U" of 0.51
Total Net FD Area Above Grade 136.00 Sq. Ft. x"U" of 0.121
Total
= 259.82
= 29.238
85.68
4.02
14.8
0
21.7304
81.4094
7.298
3.06
16.456
244.4538
4) Total Facposed Roof/Ceiling Calculations
Total Exposed Roof/Ceiling Area 1329.00 Sq. Ft.
Total Skylight Area 0.00 Sq. Ft. x"U" of 0.35 = �
Total Roaf/Ceiling Framing 10% 132.90 Sq. Ft. x"U" of 0.0258 = 3.42882
Total Net Insulation 90% 1196.10 Sq. Ft. x"U" of 0.0218 = 26.07498
Total = 29.5038
To utilize the total envelope system method, the values established by the sum of items in sections 3 and 4
shall not be greater than the sum of items 1 and 2.
1) 259.82 2) 29.238 = 289.058
3) 244.4538 4) 29.5038 = 273.9576
,„ �--�����-... _ .,�.....
;.
.. `" �
,�ONSTRUCTION R VALUE
WALL FRAUIING SECTION:
(1) Inter�.�r air film
(2) 1 /2 Gyp Board
(3) 5 1/2 inches soft wood
(4) Sheathing
(5) �Siding
(6) Exterior air film
Total R =
U=1/R-
RIM JOIST SECTION:
(I) Interior air film
(2) 6" Fibergl Batt Insul
{3) 2' X Fir Joists
(4) Sheathing
(5) Siding
(6) Exterior air film
Tofal R =
U=1/R=
. ,
•�_ i • i _
WALL SECTION �.INSULATED�
0.68 (1) Interior air film
.45 (2) 1 /2 Gyp Board
6.88 •(3) 6° Fibergl Batt Insul .
2.06 (4) Sheathing
.67 (5j Siding
0.17 (6� Exterior air film
10.91 Total R =
0•92 U=1/R=
FOUNDATIqN SECTION:
0.68 (i) Interior air film
19.00 ( 2 )
1.89 (3} 12° Concrete Block
2.06 (4) Exterior air film
.67 (5) 2" Styro
0.17 (6) 1° Styro
24.47 . Total R =
.041 2° Styro U = 1 /R =
1" Styro U �= 1/R =
CEILING SECTION LNSULATEDI:
(1) Interior air film
(2) 5/8° Gyp Board
(3) Insulation
(4) Exterior air film (still)
Total R =
U=i/R=
0.61
0.57
44.00
9�.�!
�45.79
0•22
�Ftl ING FRAMING SECTION•
(I) interior ��;� ';iim
(2) 5B" Gy� �card
(3) Insulativ;s
{4) Interior air film (stiii)
(5) 5-1 /2 " soft wood
Total R =
U = 1/R =
0.68
.45
19.00
2.06
.67
0•17
23.03
.043
� .:
1.28
0.17
S 0.00
5.00
12.13
.08
.16
0.61
0.57
34.00
0.61
6•88
42.67
.023
F
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------F6,r1212����►� 12:5�----�,1,?a:��1F,9'3---------�----- :' AIR h1ECHAN------------------------ ------
_ PAGE 04
1 �� ". ,� . � (, � . ° {. i
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R
The AirCycle� Modei "Fi�"
A low tost devite attached to the air handler t2�binet and connected
ta the low-volt�ge thermostat wiring black inside the air fiandler. By
periadically operating the tentral heating �nd cooling system fan,
diirCycJerT"° improves the effectiveness of the temperature control,
humidity and fi{tration system in a house. Doing so "averages" the air
temp�rature tonditions throughout Yhe hous� helpir�g to eliminat�
stagnant and uncomfortable air that a thermostat can`t detect.
what's "smart" about AirCyel�r71� is that it turns the house fari on
artiy after � setecte� period of time during which the central system
fan has nai aperated.
t�$nt
�rnate Fan On/Off
�n� Selection
Itton
Minute Adjustment Down
B�tton
The Air�y�ier IV[odel "F�" control w011 oper�#Q
the air handt�r unit fan for a s�l�nctable Fen t!N
time ii the f�n has been ina�s�� far a seiettable
�an OFE tlme� �� ._. . .
�
Ald'��/t�@P
Ap�ii���i"t�►�°t�:
► 1/e�ttlf�tiaN Sy���15
: �nh�nced Temp�ratur� C�an#ro)
� �nhan�ed Humidity tontro!
a �►ir Cle�ning 5y�tems
Operating VoltA�e: 24 V AC {up ta 30 Vu max)
Curr�nt dr,a_ � OA7 Amps ,�
FAN oN and OFF delay se�tcings ' FR' Model:
1 to 199 minutes is� 1 minute ic'�ttements, plus an
unlimlted settir�g ior both dN and OFF.
Notes: �
The AiKycleR ON/OFf functiori enabl�s o� disables
ehe fan reeytling fundion, but all thermostat
cantrol signals aperete notm�lly regardless of the
swftth position.
All outpuu proteded by a 3A self-resetting fuse.
Imposs�ble ta damage wilh w(rtng errors.
Figure 1 �llodel "FR"
Wiring Dia�gram {gasic U�e)
Th:nnostat Air Handler Unit Alr�yeisr Modd'FR'
W i�et?
thtstl W Wt
R (24Y AC}
{24V AC� R R
(fan) G � b • �
• G ffsn)
�'f
t (24V At comtnon)
�- " C
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COMMON VENT. VENT CONNECTOR AND COMBUSTION AIR VERIFICATION
When realacing an existing furance, the undersigned hereby verifies that the
venting has been examined and is free from rust, deterioration, obstructions,
and is securely supported and firestopped where required. Yes {) No ()
The venting system is piastic/PVC and meets all current codes and manufacturer
spec'�'ications including sizing, length, number of elbows and termination. Yss () No ()
The undersigned aiso verifies that the replacement unit is a listed assembiy
and meets the cuRent codes and manufacturers specifications. This does
inclucle AGA-GAMA Category I Central Fumace Venting Tables for fan
assisted and natural draft appliances. Yes (} No (}
The existina combustion air is sized and installed to meet the current codes
and marn �f �r .ra Snacifi��tiop� -- -- - - - - -- — YG'S (� i�0 �
When required to install a new combustion air. it will be sized and installed
To meet the cuRent codes and manufacturers specifications. Yes () No ()
When installina a new ventin4 svs4em, the undersigned hereby verfies that
it is a iisted assembly and meets the current codes and manufacturer's
specifications. This does include AGA-GAMA Category 1 Central Fumace
Venting Tables for fan assisted and natural draft appliances. Yes () No ()
Is the common vent and vent connectors sized and installed correctly after
an appliance has been removed from the common vent and vented
separately as per current codes. Yes () No ()
Appliance Tvae and Size/Common Vent and Vent Connector Information
Appliance #1 Type BTU Input Fan Assisted or Nat
Appliance #2 Type BTU Input Fan Assisted or Nat
Appliance #3 Type BTU tnput Fan A���l�i�t
Total Appliances Total Btu Input �f{�� �• 'F9
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Common Vent T�rpe � Vent Height _ Diam � �'� �� '�-� = : inches_ _
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Appliance #1 Vent Cannecfior Height ft Length ft Diameter "�I'ype
Appliance #2 Vent Connector Height ft Length ft Diameter in Type
Appliance #3 Vent Connector Height ft Length fi Diameter in Type
ALTERATIONS: (Describel
HEATIN� C�:
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COMMON VENT. VENT CONNECTOR AND COMBUSTION AIR VERIFICATION
When realacinca an existina furance, the undersigned hereby verifies that the
venting has been examined and is free from rust, deterioration, obstructions,
and is securely supported and firestopped where required. Yes () No ()
The venting system is piastic/PVC and meets all current codes and manufacturer
specifications including sizing, length, number of elbows and teRnination. Yes () No ()
The undersigned also verifies that the replacement unit is a listed assembly
and meets the cuRent codes and manufacturers specfications. This does
include AGA-GAMA Category I Central Fumace Venting Tables for fan
assisted and natural draft appiiances.
The existing combustion air is sized and installed to meet the current codes
and manufacturers specifications.
When required to install a new combustion air. it will be sized and installed
To meet the current codes and manufacturer's s�fications.
Yes( ) No( )
Yes ( ) No ( )
Yes()No()
When installina a new ventinn svstem, the undersigned hereby verifies that
it is a listed assembly and meets the current codes and manufacturer's
specifications. '�'his does include AGA-GAMA Category I Central Fumace
Venting Tables for fan assisted and natural draft appliances. Yes () No ()
Is the common vent and vent connectors sized and installed coRectly after
an appliance has been removed from the common vent and vented
separately as per current codes. Yes () No ()
Appliance Tvae and Size/Common Vent and Vent Connector Information
Appliance #1 Type BTU Input Fan Assisted oc Nat
Appliance #2 Type BTU Input Fan Assisted or Nat
Appliance #3 Type BTU Input Fan Assisted or Nat
Total Appliances Total Btu Input
Common Vent Type Vent Height Diameter inches
Appliance #1 Vent Connector Height ft Length ft Diameter in Type
Appliance #2 Vent Connector Height ft Length ft Diameter in Type
Appliance #3 Vent Connector Height ft Length ft Diameter in Type
ALTERATIONS: (Desc�ibel
HEATING CO:
Signed By: Date :
�
_
CIIYOF
FRiDL�,Y
FRIDLEY MUNICIPAL CENTER • 6431 Ur1IVERSITY AVE. N.E. FRIDLEY, MI�T 55432 •(612) 571-3450 • FAX (612) 571-1287
Septeml�r 21, 2�
Design Images
13971 Holly St NW
Andover, MN 55304
Re: Final Inspection at 5681 Arthur Street NE, Fridley
Dear Sirs:
A final inspection was conducted on September 21, 2� for the construction of the house &.
garage located at the above noted address. It was determined that the constcuction complies with
the approved plans and the structure is approved for occupancy. The following item was noted
which must be completed �fore the building permit can be finaled;
Provide sod in the front and side yazds by June 1, 2001.
We will expect the above item to l� completed on or before the scheduled date and a reins�ction
called for. If you have any questions on this matter, please feel free to contact me at 572-3602.
Sincerely,
RON JU
Building
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COMMON VENT VENT CONNECTOR AND COMBUSTION AIR VERIFICATION
When reolacins� an exlstlns� furance, the undersigned hereby verifies that the
venting has�been examined and is free from rust, deterioration, obstructions.
and is securely supported and firestopped where required. Yes () No ()
The venting system is plastic/PVC and meets all current codes and manufacturer
speafic�ons including sizing, length� number of elbows and termination. Yes () No ()
The undersigned also verifies that the replacement unit is a listed assembly
and m�ts the current c,odes and manufacturers specifications. This d�s
include AGA-GAMA Category I Central Fumace Venting Tables for fan
assisted a�d natural draR appliances.
The existins� combustion air is sized and installed to meet the cunent codes
and manufacturer's speafications.
When required .to install a new combustlon air. it will be sized and installed
to meet the current codes and manufacturers specifications.
Yes ( ) No ( )
Yes ( ) No ( )
Yes ( ) No ( )
When installins� a new venUns� svstem� the undersigned hereby verifies that
it is a listed assembly and meets the current codes and manufacturers
specifica�ons. Thfs does include AGA-GAMA Category I Central Fumace
Venting Tables for fan assisted and natural draft appliances. Yes () No ()
Is the cammon vent and vent connectors sized and installed correctly after
an appliance has been removed from the common vent and vented
separately as per current codes. Yes () No ()
A°�liance Tvae and Size/Common Vent and Vent Connector Information
Appliance #1 Ty� BTU Input Fan Assisted or Nat
Appliance #2 Type BTU Input Fan Assisted or Nat �
Appliance #3 Ty� BTU Input Fan Assisted or Nat
Total Appliances Total Btu Input
Common Vent Ty� Vent Height Diame#er inches
Appliance #1 Vent Connector Height ft Length ft Diameter in Type
Appliance #2 Vent Connector Height ft Length ft Diameter in Type
Appliance #3 Vent Connector Height ft Length ft Diameter in Type
ALTERATIONS: (Describe)
f
P� .
HEATING CO:
Signed By: Date :
Building
Inspections
763-572=3604
STTE ADDRESS _
THIS APPLICANT IS:
PROPERTY OWNER/
TENANT
CONTRACTOR
BUILDING
RESIDENTIAL APPLICATION
CITY UF FRIDLEY
YOUR E-MAIL ADDRESS
■ • ��
PHOAIE:
SUBMIT A COPY OF STATE wCENSE #_
YOUR STATE LICENSE ADDRESS:��
WITH APPLICATIOIV �o�'t�� �
PROPERTY TYPE
PERNIIT TYPE �
O
�rrE oF wo�: o
0
,Y/NEW
FINISH ❑ ROOF
❑ SID1NG
❑ SWIlIZM
DESCRIBE WORK BEING DONE: G1 �.NSLI �T •
SIZE OF IlVIPROVEMENT
NUMBER OF SQUARE,S
GA1tAGF>S
PROPOSED S1ZE:
PROPOSID HEIGHT:
❑ HOUSE 8c GARAGE
O ATTACi�D GARAGE
❑ DEfACHED GARAGE
*� ,
Permit No.: D`1 2-
Received By: u��-
Date R��d� J U. 1 4 2
:� �f�, G2 ' /
d re� ��✓r-F�
L�7�"1 ` !� 1 k-- l
STATE Z� 3�Y3 a
EXP DATE S� �
i'. ` `_ CTfY AN� STATE! ZIP�
❑ DRAIN TILE
0 OTFIER
HEIGHT
BASEMENT RHvIOD iNC' SUBMIT•
1. Existing Floor Plan
2. Propo� soot pien
3. List of structwal members to ye used
Ft
SIDIIVG FOR NEW CONSTRUCTiON 1NCLUDWG DF,CKS.
� V�� D�t ADDTd'IOATS & PORCHES SUBMIT•
❑ Aluminum ' � Trim 1. Site PlmdSurvey showing the existing stntcwres
� Od►er . � Fascia � and proposed pm,j�t.
R'INDOR'S Z. Two sets of construcdon p(ans
IN EXISTING OP�IVINGS OYes ONo LOCATION OF WINDOWS 3• E"e�' Calcula�°tu .,
OR FOR NEW OPEIVATGS-DESCRBE SIZE OF
OPENII�iG CHAIdCrFS 8c
TYPE OF WAiDOW TO BE INSTALLED NUMBER OF �VIIdDOWS
ALL FEES ARE BASED OAT VALUATION, INCLUDING THE COST OF LABOR AND MATERIAIS;
V,
Permit Fee
Plan Review
Fire Surcharge
Surchar�e
License Surcharge
SAC Chazge
Curb Cut Escrow
Erosion Control
Park Fe,e
Sewer Main Charge
Total Dne _
OCCIJPANCY
$ � See Back Page for Fee Schedule
$ 65% of Building Permit Fee
$ �$ b .OU 1 times the total job valuation
$ ('� � � .0005 x Pernut Valuation Minimum $.50
$ S��ij $5.00 (State Licensed Residential Contractors)
$ $1675 per SAC Unit (Plans to MWCC for determination)
$ ft+6ft= ftx$21=$ �
$ $450 Conservation Plan Review
$ Fee Determined by Engineering
$ Agreement necessary ( ) Non Necessary ( )
$ (6 � Z1 _ Make checks payable to: Citv of Fridlev Attach
THIS IS AN APPLICATION FOR A PERMTf NOT VALID UNTIL PROCESSED
I hereby apply for a building permit and I aclaiowledge that the information above is complete and accurate; that the work will be in
conformance with the ordinances and codes of the City of Fritiley aad with the Minnesota Construction Codes; that I understand this is not a
pemut but only an application for a permit and work is not to start without a permit; that the work will be in accordance with the approved
plaa in the case of all work which requires review and �p�hoval of plans.
SIGNATURE OF
.
"�� Page 2- Building Residential Application
� - BUII..DING PERMIT FEE SCHEDULE
The Chief Buildin.g Official shall, before issuing permits for the erection of any b.uilcli.ng< or °�
structure, or for any ad.dition to any exis�ing. bu.ildin� or structure� or �or anx alter.ation or repau� "���
to any existing building or structure, upbn ap�3lication tl�eie�c�re, arequire'the`�payment by ihe
applicant for such permit of fees to the aznount herein below set �ertyh and in the manner herein
provided to-wit: _ � � �,,.,;, �:�; . , . �. � . � �� , � '�� �.x �
� _ :. ; . . • � n' ," . ' . :.p . , '=a � � � .' ,
r�:� �
VERIFICATION OF FOUNDATION
Permits for construction will be issued a minimum of 24 hours from the time of application ta
allow for proper review of proposed structure and of the construction site.
A Certificate of Survey of the lot, showing the loca.tion of the existing foundation will be
required before proceeding with the framing. New Houses Onlv
City o�Fridley v . �;:,F,.,fl
Buildi.ng Inspections Deparlment� ` �
6431 University Avenue NE
Fridley, MN 55432
763-572-3604
Fax: 763-502-4977
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Building
Inspections
763-572-3604
DAtD �Wr '� /
S1T� ADDRESS �
Tj�II$ APPLICANf IS:
Y
PROPERTY
OWNER/
TENANT
CONTRACTOR
�.
MECHANICAL
RESIDENTIAL APPLICATION
CITY �F FRIDLEY
YQUR E.�IAIL ADDRESS
■ • � Ol' )':�M� � �
Pernait No. �
Received By:�
D��'��
. _ _--- - � �, STATE ZIP
ADDRESS: .
COMPANY NAME.—
SUgMTT A COPY OF �NTACT PERSON:
YOUR STATE S'I'ATE LIC�ISE # EXP DATE
L.ICENSE WT!'H nnn�ss: P.v �i' l f �.� � A1'�� sTA�,�Iz 5�
APPLICATTON PHONE��� � �il��� � � F� ��� - y 3 �f -1(o a
,
PERIVIIT ,fYPE �1NGLE FAMILY � TWO FAMILY ❑ TOWNHOUSE
❑ NEW O REPLACEN�TIT �TION/REMODII.
�rYrE oF woxx: �
DETAILED DESCRIPTION OF WORK
� .�� ��,r�—
PER MS 16B:665 the permit fee is a minimnm �f S15.OD or 5% of the total cost up to 5500.00, whichever is greater, for the
itnproveanent, installation or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor )
I,abor cost tmder $300 =$15.00. L,abOr cost between $300 to S5� = cost of labor x.OS ° �
FOR PROJECTS WHERE LABOR EXCEIDS $500, FEES ARE BASID ON S 10.00 PIIt FiXTC3RE, EXCEPT WHERE NOTID. FIXTURFS: (II�IDICATE TOTAL
MJA+IDER OF EACH BF.I:OV� MODEL: SIZFIBTU
Equipment Instalied . . MFG: STZEfBT1J
MFG: MODEL:
MFG: MODEL: SIZE/BT[3
A/C $25.00 -,'—�,�FIRF.PLACE (GAS) 515.00 GAS RANGFJOVF�1$IO.�
AIR TO AIR EXCHANGF.SR $15 FIItEPLACE (W�D) $35.� TTER► CiAS GRII.L•$10.�
CE $35.00 GAS ZJl�i1T ii'I'R: $10:�
BCHIMNEY SLWER $10.� -"as� DRYER $10.00 POOL HEATER $35.�
�C DUCf WORK $1Q00 dAS PIPING $]0.� VENT'II.ATOR $15.�
- • - .a� �-. . r- _r,,.. _ . _ _ . . .. _
Permit Fee $ Number of fixfures @$10.00 x 10. _
Surcharge $ .50 Number of �6xdires @ $15.00 x $15.00 = $
TOTAL DiJE $ Number of fnctures (a� $Z5.00 x$25.00 =$
Number of fixtures @ $35.00 x �"35.00 = $
State Surcharge = $ 0
Tota1= $ .
THIS IS pDi AppLICATION FOR A PERMTI NOT VALID UNTII- PROCESSED
I hereby apply for a building permit and I aclrnowledge that the information above is complete and accurate;•that the work will be in
conformance with the ordinances and codes of the City of Fridley and with the Minnesota �Construction Codes; that I understand this is
not a permit but only an application for a permit and work is not to start without a permit; that the work will. be in accordance with the
approved plan in the case of all����hich re�uire�.s.�iew and approval of plan� �.../� _ 1/ .. . �
STGNATURE OF
City of Fridley
Building Inspections Department .
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
FAX• 7��-St12-4977_.
_'
,.•
REQUIRED iNEORMATION NEEDED TO PROGESS PERMIT
� RESIDENTIAL PERMIT APPLICATION HVAC
[] NEVV HONlES/ADDI�IONS ❑ EXISTlMG HOME ❑ MAKE-UP AIR
REQUIRED FOR NEWIEXISTING FiOMES
1. Combvstion Air (See note below) .
-_-- a, or so #'u.e fi�vi�ivfl�fi Aa�enti�ents _
. : _ ..__.. .
--_ . _ _. ---- - - ---
b. Na�iu�al. G�as or Propane!!�C`iC-C�iapter 3 with MN Amen e��s
2, rqake-u� Air (See note belaw)
a. IlvIC Cha�ter 5 with NIN Amendments
3. V�antin.g
a. Gas a�pliances 1FGC Cha}�ter S with Ml�T Amend.ments
� b. Fuel other than gas IMC Chapter 8 with MN Amendments
REQUIRED FOR NEW HOMES
4. Heaf loss & cooling loa.d per room
a Requir�d on new construction IMC 13�6.0312
5. Ven.tilation .
a, Per MN Energy Cocie 7670 or 7672
6. Duct Design Per IMC 1346.0603.2
a. ACCA Manual D .
,
NOTE: Centerpoint Energy Mechanical Code Guidelines software may be used for �
combusiion and make up air.� calctYlafions �
Building PLUMBING Permit No.:
Inspections RESIDENTIAL APPLICATION Received By:
763-572-3604 CITY OF FRIDLEY Dat�d:J U N' %
DATE YOUR E-MAIL ADDRE,�iSS
STI'E ADDRESS a � jls_�,,� ,�+ • Av G
THIS APPLICANT IS: ��g� O OWNER �ONTRACTOR
PROPERTY NpME:
OWNER/ ADDRESS: CITY STATE ZII'
TENANT
PHOATE:
CONTRACTOR N�: ,
SUBMTf A COPY OF STATE LICENSE # DATE I
YOUR STATE ADDRESS: � -�'TF/1 G%U U�STATE�v�Lir �l �7 �
LICENSE WITH pHONE ��C.Q� — ���" - 3�7� Fnx
APPLICATION • .
PERMIT TYPE �INGLE FANIILY ❑ TWO FAMII.,Y . ❑ TOWNHOUSE -
TYPE OF WORK: � � ���E�NT
DETAILED DESCRIPTION OF WORK ��I'� ��/�T��/
PER MS 16B.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the
improvement, installation or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor )
Labor cost under $3Q0 =$15.00. I,abor cost between $300 to $500 = cost of labor x.OS =
FOR PROJECfS WE�RE LABOR EXC�EDS $5�, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHER� NOTED. FIICfURES: (AIDICATE TOTAL
ER OF EACH BELOV1�
BATH SINKJLAV FLOOR DRAINS ,� SHOWER • WATER PII'ING
_ BATHTUB GAS PIPING �n crirtrcF vse) SWIIVIlvII1VG POOL _ WATER SOFfNER ($35)
_ CLOTf�S WASHER � KITCI�N SINK ,_(_ WATER CLOSET _ BACKFLOW PREV. ($15)
_ DISHWASI-�R _ LAUNDRY TRAY WATER HEATER ($35) FOR IRRIGATION
_ WATER N�TER _ OTI-IER
N
, _ .- rt, ��„.� �, � � , . ,
Pernut Fee $ Number of fixtures @$10.00 � x$10.00 =$ 0•
Surc e .50 Number of fixtures @$15.00 x$13.00 =$
TOTAL DUE $ Number of fixtures @$35.00 x$35.Q0 =$
State Surcharge = $ .50
Tota1= $
THIS IS AN APPLICATION FOR A PERMIT NOT VALID UNTIL PROCESSED
I hereby apply for a building pernut and I aclmowledge that the information above is complete and accurate; that the work will be in
conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is
not a permit but only an application for a permit and work is not to start without a permit; that the work will be in accordance with the
approved plan in the case o a11 work wluch requires review and approval of lans.
SIGNATURE OF APPLIC a + PRIIVT N t, �Y�DATE�j�_
_ �»
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
FAX: 763-502-4977
BU11C�lrig MECH�NjCAL Pe�it rto. • c�`� � l 3 3�
Inspections RESIDENTIAL APPLICATION Received By
763-572-3604 CITY OF FRIDLEY D��'�
DATE � ` U� YOUR E-MAIL ADDRESS �e I .
SITE ADDRESS � l� Fi � i�-�-^r VJ' S� � ��
THIS APPLICANT IS: ❑ OWNER �CONTRACTOR
PROPERTY N�ME: r-T ✓�✓�.L,•� -
OWNER/ ADDRESS: CiTY STATE ZIP
TENANT •
PHONE:
CONTRACTOR �p�pqNy N�: c s u..�¢.i
�
SUBMIT A COPY OF ��TACT pERSON: i ,
YOUR STATE STATE LICENSE #_ � G S� a O CQG EXP DATE
LICENSE WITH ,�DRESS: a ZU'� �avt �Vt�W � C[TY STATE W�'ZIP
APPLICATION PHONE l��T� �� t U� �_ FAX �� SfI � L� T�� �5��
-- - - - _-- - - - - -- - -- - -
PERMIT TYPE �GLE FAMILY ❑ TWO FAMILY D TOWNHOUSE
TYPE OF WORK: 0 NEW �'[tEPLACEMENT � ALTERATION/REMODEL
DETAILED DESCRIPTION OF WORK ' � � �� .
PER MS 16B.665 the permit fee is a minimam of $15.� or 5% of the total cost up to $500.00, whichever is greater, for the
improvement, installation or replacement of a residential fixture, excluding the fixtiues. (T'his should reflect only the cost of labor )
Labor cost under $300 =$15.00. Labor cost between $300 to $500 = cost of labor x.OS =
FOR PRpJECTS WI-�RE LABOR EXCEEDS $500, FEES ARE BASED ON $10.� PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (QdD1CATE TOTAL
NUIv�ER OF EACH BEIAVi�
EquipmentInstalled MFG: �C� MODEL: �� SIZE/BTU �i �
MFG: MODEL: SIZE/BTU
MFG: MODEL: SIZEBTU
A/C $Z5.00 XFIREPLACE (GAS) $15.00 • _GAS RANGElOVEN $10.�
AIR TO AIR EXCHANGEER $15 FiREPLACE (WOOD) $35.00 NEW GAS GRILL $lO.OQ
_BOILER $35.00 _FURNACE $35.00 _GAS UNIT HTR $I0.00
Ci�IIMNEY LINER $10.00 GAS DRYER $10.00 _POOL HEATER $35.00
DUCT WORK $10.00 GAS PIPING $10.00 VENf[LATOR $15.00
, ,�_ - " .� � �. �" e ` ._ ����7. ��
�
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. 4 � . ,. � _..�� ., << ��. �, . ., ,
Permit Fee $ . Number of fixtures @$10.00 x$10.00 =$
Surcharge $ .50 Number of fixtures @$15.00 �_ x$ I 5.00 =$� � U
TOTAL DUE $ Number of fixtures @$25.00 x$25.00 =$
� Number of fixtures @ $35.00 x $35.00 = $
State Surchazge = $ .50
� Tota1= $ 1 S ��
THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED
I hereby apply for a building permit and I aclaiowledge that the information above is complete and accurate; that the work will be in
conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is
not a permit but only an application for a permit and work is not to start without a permit; that the work will be in accordance with the
approved plan in the case of all work which requires review and approval of plans.
SIGNATURE OF APPLICANT �, _ __ PR1NT NAME� V>� (i✓�(�DATE "% o� 7`G% `
�-
'z :
C;ity of !� ridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
FAX: 763-502-4977
City of Fridley Residential Mechanical Application Page 2
�_ � REQUIRED INFORMATION NEEDED TO PROCESS PERNIIT
RESIDENTIAL PERMIT APPLICATION HVAC
� NEW HOMES/ADDITIONS ❑ EXISTING HOME ❑ MAKE-UP AIR
REOUIRED FOR NEW/EXISTING HOMES
1. Combustion Air (See note below)
_ a. Oil or solid fuel IMC Chapter 7 with MN Amendments
b. Natural Gas or Propane/IFCrC Chapter 3 with MN Amendments
2. Make-up Air (See note below)
a. IMC Chapter 5 with MN Amendments
3. Venting
a. Gas appliances IFGC Cha.pter 5 with MN Amendments
b. Fuel other than gas IMC Chapter 8 with MN Amendments
REQUIRED FOR NEW HOMES
4. Heat loss & cooling load per room
a. Required on new const�uction IlVIC 1346.0312
5. Ventilation
a. Per MN Energy Code 7670 or 7672
_ 6. Duct Design Per IMC 1346.0603.2
a. 'ACCA Manual D
NOTE: Centerpoint Energy Mechaaical Code Gaidelines software may be used for
combnstion and make-up air calculations.
�
�tabiiehea iA iasz INVOICE N0. �
L�'i SUR�EYS COMPANY, INC. F.B.NO. �-�+
LAND SURVEYORS SCALE: 1" a 20�
REGISTERED UNDER THE LAWS OF 3TATE OF MINNE.SOTA o p�tee �ron Abrnm�ent
7801 73rd Avenae Nostt► 918—b80-0093 ❑ p��� yy� � Set
Fn: Na 680-86E8 tor srcwaQon oNy
]IUnneapolle, Mlnneaote 86428 XppQO Denotea Exlsting Elevatbn
�iururynrs (arrtifirtt#r �.� �t� ���+ a•���
— u�c� s�r� or�,�,
rrorE: t�opoaed gr�ae ars eubject
to ree�dte of eop testa
DESI(�V IINA(�S . Propoeal bi+Jldln9 IntorrtooUon
m�ot ba cfesclted with �roved
Property located i.n Section �d�9 P►� a�d davetopma+t or
�. 24� Totanship �� B�ge 24� `°"'g' ��8'" ��ro Pim bst�e arcwaUon
AIIakfl CWIIIL}I� �80Y8 r�.936:7 855.54 ��a � constRrotla�.
gg�gg opoeed Top of B�ook
Y'/o �3 S�5 Propoead ctar�e Floor
Z'd P'roposad Loreat Flow
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providad by cHent.
We hmeby cerlify lhot lhte is a irue arid wrrect repreaenlotlon of
o s�nvey ol !he botmdortea of� ihe obove deacribed IaM ond ►He
locolion of oil bupdk�gs and vieible ancroaehments, if rtny, Irom w on
soid lond.
Surveyed by ua lhis 26t�uy o( I'�v 2�
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Chatee F. Artdaeon, hprm, Rsq. No.21733 or
Greqoo'y R. Praech �nn Reg No. 24992
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